GayWrites Talks Being LGBT & in Therapy

Therapy is often a confusing and difficult process for a lot of people. The biggest part of the battle for some folks in just getting in the door.  And if you identify as LGBTQ+ you may also have to consider if you are able to find an affirmative provider. When I came across the video from YouTube creator GayWrites below, I thought it would be a good clip to share here. In this 7+ minuted clip you'll get a sense of what kinds of therapy are out there and how you might go about finding, and paying for therapy.

Check it out below!

What does it mean to be sex positive?

I was having a discussion with some colleagues recently about how we communicate with clients about our own comfort in talking about sex and sexuality issues in counseling. I said that I considered myself to be a therapist that is, "sex positive, kink positive, LGBTQ and poly affirming.

"But what does that really mean?

Being sex positive isn't about having a healthy dose of enthusiasm for sex, but more so about adopting a perspective that is affirming of diverse and individual forms of sex and sexuality. That is, where  traditional notions of sexuality are about controlling behavior through shame, judgment and perhaps guilt, being sex positive means operating from an entirely different lens. It means affirming an individual's right to enjoy the kind of sex they're having, who they're having it with and however frequent feels right for them.  That is, as long as that sexuality is between consenting parties (legally, ethically and morally).

Being sex positive means affirming the various ways in which people enjoy expressing themselves through their sexuality. In essence, sex positive reinforces each individual's right to self-determine what works for them sexually.

As a therapist, this means that I approach each client's sexuality with an open mind. Instead of inducing shame, it's about helping clients get the most out of their sex lives while minimizing any concerns or negative consequences. Often, this includes helping couples figure out ways to rekindle their sexual lives and helping individuals become more comfortable in owning their desires and attractions.

Many of us have been taught that sex and sexuality are things that we should feel shame about.  Sex positivity isn't about being pro sex but more so about reducing that shame and stigma so that whether you are highly sexual or asexual, you find the best way to make your sexuality work for you.

Should You Be the Same Race or Gender as Your Therapist?

One of the things that I am most often asked in my phone consultations with folks is about matching between client and therapist along gender or race lines. That is, should you be the same gender or race as your therapist?  As with most answers in psychology...it depends!

Finding the right therapist to work with is no easy feat. First, there is the research. You scour search results of sites like Google or sort through results on directory sites like Psychology Today in order to find a mental health professional in your area (with payment terms that you're comfortable with). You may not even know what you're supposed to be looking for! Should you have someone of your own race or should you not care? Does it matter? What about gender? Then, you make a quick call or schedule your first session and anxiety sets in. Now, you actually have to go.

It takes a lot out of you.

Research exists on the topic of matching between client and therapist along racial and/or gender lines, and the results are mixed.  Based on the research that I've seen, there doesn't seem to be much difference in terms of treatment outcomes as it relates to therapist/client matching. That is, you are likely to gain similar outcomes if you are Black man meeting with a Black male therapist or a While male therapist. Are you surprised? Me too.

Of course, this all starts with the basis that there is no, or very limited, bias on the part of the therapist. The research indicates that therapists of all races, who are comfortable with their own racial identity and competent in working with clients of difference racial groups, are equally efficient. That's particularly good news if you live in an area where you are not able to find a therapist of your own race, if that is your preference.

When it comes to race, it seems that you can be sure a therapist of any race that is competent in working with your racial group can be effective at helping you work through your biggest concerns.

Another idea that I found interesting about the research is that the length of treatment IS affected by therapist, client match. Specifically with regards to race, there is research that indicates that while match doesn't so much matter for White folks, Black folks are more likely to stay in therapy longer when matched with Black therapists.

The research on gender (or sex) matching between therapist and client is also mixed. There is some research that indicates that, similar to race, gender matching makes no significant difference in terms of treatment outcomes. However, there is research that indicates that women tend to stay in treatment longer when matched with women therapists. Inversely, men may be more likely to drop out of therapy, and sooner, when matched with male therapists. Go figure.

It should be noted that all research attempts to explain trends that are able to be generalized about the population at large. Some research does a much better job at this than others.  So take all of this information with a grain of salt.

At the end of the day, what matters most is who are you most comfortable sitting across from. When you're empowered with an answer to that question, you will be much more comfortable and prepared to work through your concerns with a therapist than you can grow to trust and lean on.

Additional suggested reading on the topic: Your Therapist is White. You're not. Is this a problem?

Sources:

Cabral, R. R., Smith, T. B. (2011, October 11). Racial/Ethnic Matching of Clients and Therapists in Mental Health Services: A Meta-Analytic Review of Preferences, Perceptions, and Outcomes. Retrieved April 4, 2017, from http://scholarsarchive.byu.edu/cgi/viewcontent.cgi?article=1079&context=facpub

Flaherty, J. A., MD, & Adams, S., PhD. (1998, January 01). Therapist-Patient Race and Sex Matching: Predictors of Treatment Duration. Retrieved April 04, 2017, from http://www.psychiatrictimes.com/articles/therapist-patient-race-and-sex-matching-predictors-treatment-duration

Jones, E. E. (1978, January 01). Effects Of Race On Psychotherapy Process And Outcome: An Exploratory Investigation. Retrieved April 04, 2017, from http://insights.ovid.com/psychotherapy-theory-research-practice/psytr/1978/10/000/effects-race-psychotherapy-process-outcome/4/01437416

Sterling, R. C., Gottheil, E., Weinstein, S. P., & Serota, R. (1998, July). Therapist/patient race and sex matching: treatment retention and 9-month follow-up outcome. Retrieved April 04, 2017, from https://www.ncbi.nlm.nih.gov/pubmed/9744135

Lady Gaga Opens Up About Living with PTSD

Performer Lady Gaga recently opened up about living with Posttraumatic Stress Disorder (PTSD). The condition affects about 8 million US adults each year (US Department of Veteran Affairs).  Lady Gaga recently penned an open letter for her Born This Way Foundation that I am sharing here in its entirety to help those who may be living with PTSD.

She writes:

"I have wrestled for some time about when, how and if I should reveal my diagnosis of Post Traumatic Stress Disorder (PTSD). After five years of searching for the answers to my chronic pain and the change I have felt in my brain, I am finally well enough to tell you. There is a lot of shame attached to mental illness, but it’s important that you know that there is hope and a chance for recovery.It is a daily effort for me, even during this album cycle, to regulate my nervous system so that I don’t panic over circumstances that to many would seem like normal life situations. Examples are leaving the house or being touched by strangers who simply want to share their enthusiasm for my music.

I also struggle with triggers from the memories I carry from my feelings of past years on tour when my needs and requests for balance were being ignored. I was overworked and not taken seriously when I shared my pain and concern that something was wrong. I ultimately ended up injured on the Born This Way Ball. That moment and the memory of it has changed my life forever. The experience of performing night after night in mental and physical pain ingrained in me a trauma that I relive when I see or hear things that remind me of those days.

I also experience something called dissociation which means that my mind doesn’t want to relive the pain so “I look off and I stare” in a glazed over state. As my doctors have taught me, I cannot express my feelings because my pre-frontal cortex (the part of the brain that controls logical, orderly thought) is overridden by the amygdala (which stores emotional memory) and sends me into a fight or flight response.  My body is in one place and my mind in another. It’s like the panic accelerator in my mind gets stuck and I am paralyzed with fear.

When this happens I can’t talk. When this happens repeatedly, it makes me have a common PTSD reaction which is that I feel depressed and unable to function like I used to. It’s harder to do my job. It’s harder to do simple things like take a shower. Everything has become harder. Additionally, when I am unable to regulate my anxiety, it can result in somatization, which is pain in the body caused by an inability to express my emotional pain in words.

But I am a strong and powerful woman who is aware of the love I have around me from my team, my family and friends, my doctors and from my incredible fans who I know will never give up on me.  I will never give up on my dreams of art and music. I am continuing to learn how to transcend this because I know I can.  If you relate to what I am sharing, please know that you can too.

Traditionally, many associate PTSD as a condition faced by brave men and women that serve countries all over the world. While this is true, I seek to raise awareness that this mental illness affects all kinds of people, including our youth. I pledge not only to help our youth not feel ashamed of their own conditions, but also to lend support to those servicemen and women who suffer from PTSD. No one’s invisible pain should go unnoticed.

I am doing various modalities of psychotherapy and am on medicine prescribed by my psychiatrist.  However, I believe that the most inexpensive and perhaps the best medicine in the world is words. Kind words…positive words…words that help people who feel ashamed of an invisible illness to overcome their shame and feel free. This is how I and we can begin to heal. I am starting today, because secrets keep you sick. And I don’t want to keep this secret anymore.

A note from my psychologist, Dr. Nancy: ‘If you think you might have PTSD, please seek professional help. There is so much hope for recovery. Many people think that the event that stimulated PTSD needs to be the focus. Yet often, people will experience the same event and have completely different reactions to it. It is my opinion that trauma occurs in an environment where your feelings and emotional experience are not valued, heard and understood.  The specific event is not the cause of traumatic experience.  This lack of a “relational home” for feelings is the true cause of traumatic experience.

Finding support is key.

Click here or visit the National Institute for Mental Health for more information on PTSD in all its forms and where to find help. If you are in crisis now, call the National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8225)." 

What is PTSD?

Posttraumatic stress disorder (or PTSD for short) has become a more widely recognized mental health condition in recent decades, but what is PTSD?  I hope to provide you with some basic and insightful information below.PTSD was originally a term applied to soldiers returning from war, but it wasn't always called PTSD as it is today.  Previously, the cluster of symptoms was categorized as "shell shock" or "soldier's heart".  Thankfully, psychology began to recognize that not only soldiers could experience posttraumatic stress disorder and began to more acutely study and accurately define a condition that affects about 8 million people each year in the United States. PTSD can be a crippling condition but can be treated effectively with a supportive therapist.But what is PTSD exactly? The current criteria for PTSD include the following:

1. Exposure to actual or threatened death, serious injury or sexual violence
2. Symptoms following the event such as intrusive memories, recurring dreams, flashbacks or other bodily reactions to cues related to the event
3. Avoidance of things associated with the event (for example: similar or actual location, people or related feelings or thoughts)
4. A generally negative change in thoughts or mood following the event(s)
5. Changes in level of reactivity or heightened arousal beginning or worsening after the event(s) (for example: being startled very easily, feeling "on edge" or having difficult sleeping)

All these symptoms must be met for a period longer than a month and must occur following the activating event(s).  Traditionalists typically view the development of PTSD as very rigid and involving "serious bodily injury", however myself, and many contemporary therapists, also view longstanding physical and emotional abuse as potential experiences leading up to the development of PTSD.Additionally, historically PTSD was thought to only affect those with direct experience of the event(s) but current criteria indicates that people who have witnessed, or know a close family or loved one being harmed, may experience PTSD as well.So what type of events do we think of relating to PTSD?

• Directly experienced the event(s) or witnessed the event(s)
• Had serious physical injury from the event(s)
• You believed you or a family member (or loved one) was in serious danger during the event(s)
• You felt helpless or otherwise had a severe reaction to the event(s) such as shaking, crying, or feeling apart from the surrounding area

Given the presented criteria, you can see how many of us in the totality of our life experiences could potentially be affected by PTSD at some point in our lives.  If you believe you or someone you love might be dealing with the criteria mentioned above, I recommend you seek out consultation with a therapist to discuss ongoing support. Even if you don't meet the diagnostic criteria of PTSD, there is always room to be healthier and feel liberated from experiences that may be haunting you or limiting your progress in life.